Strahlentherapie des Mammakarzinoms

The benefit of adjuvant radiotherapy after breast-conserving therapy is well established. A significant reduction of the local recurrence rate according to the results of the Early Breast Cancer Trialists’ Collaborative Group has been sufficiently demonstrated. The overall survival rate is increased by about 5% after 15 years (p=0.005). Radiotherapy reduces the local recurrence rate by about a factor of 3. Four prevented local recurrences prevent one death. Almost all breast cancer patients need radiotherapy after breast-conserving surgery. In most cases the therapy is well tolerated. One of the most common acute side effects however is skin erythema and mild to moderate edema of the irradiated breast. Deformation of the breast as a late side effect induced by radiotherapy rarely occurs since the advent of modern radiation techniques. The same is valid for potentially life-threatening late effects of radiotherapy like secondary cancers or heart damage. The last-mentioned can be avoided with modern techniques. One objective of this article is to analyze current studies and identify subgroups of patients who do not benefit from radiotherapy.